Can my medical insurance pocket their money hindmost after paying?
i had a car wreck surrounded by october of last year. i went to the emergency room that dark and gave them my medical insurance information. i went support the next day because i passed out. i used like insurance information. well i also have med. salary on my car insurance. after my medical insurance paid their portion i give my car insurance company the remainder of the bills and they paid the rest. they if truth be told over paid the hospital. my medical insurance company found out that i had med. wages and decided since it was "injuries sustained from an automible accident" they wernt going to pay envelope and have requested their money back from the hospital, which they did. i verbs to get the bills from the hospital because the insurance company took the money back. the hospital sent me the overpaid portion of the bill and in a minute my medical insurance has sent the hospital another letter requesting more money rear legs because they were "overpaid". can that medical insurance company do that? if their not going to pay because of the type of injury..consequently why do i pay insurance every two weeks? its pointless because all the money is coming out of my pocket. im at my wits cease on this. i cant get any kind of answer from anybody. somebody please please please minister to!
Answers:
yes this is perfectly legal. Car insurance should other pay the bills incurred due to an auto accident.
Yes they can. In fact... this is the way it works.
Auto pays for injuries sustained within the accident.
Typically, Health Insurance pays your medical claims first. If there's a settlement, the auto pays for the injuries. Then, your health insurance is refund.
If you received a settlement, you are obligated to pay the hospital. If there be no settlement, your auto should be paying the hospital. If your auto is exhausted, then send the proof the auto insurance is exhausted to the medical insurance; & typically, they will wages more.
Yep. It's allowed. What happen was your medical insurance didn't check for coordination of benefits - some injuries automatically flag claims for that - basically, it's an insurance company's means of access of trying to "weasel" out of paying a claim. Why should they pay if someone else is responsible.
Your car insurance should hold been the primary insurance in this skin. You need to contact them ASAP and let them know what's going on, so they can take-home pay what's left of the bills so you don't get sent to collection and your credit ends up surrounded by the toilet. Source(s): I'm a medical biller
Yes, a form insurance company can absolutely take hindmost money after paying a claim, if its determined that they weren't the ones responsible for the payment.
If your auto's med pay be determined to be primary for the accident, then your strength insurer would request a refund for the payment they made as primary.
If your strength insurer should be liable for any amounts after the auto carrier's med pay exhausted, then the hospital would necessitate to send them an itemized statement of exactly what was remunerated by your auto carrier. That way, the robustness insurer can coordinate the benefits and make sure that the same services aren't individual paid twice. Source(s): 15 years working for health insurance companies and medical providers
Indeed they can.
Your medical and car insurance aren't supposed to put you in a better position than you be before the accident, so if they overpaid they sure should procure that money back. When you got the money from the hospital the best piece to have done would have be to call your medical insurer right then and return the money.
Also, your medical insurer isn't asking for the money rear because of the type of injury, they're asking for it back in slice because the injuries were the result of a car luck. State laws are clear in that your motor insurer should have paid first next to your regular medical coverage paying what your car insurer does not. Medical payments coverage, a terrific add-on to your auto insurance, should be used for medical bills up to that time anything else (medical payments can also pay lost wages, but medical bills should be paid until that time lost wages), so your medical insurer should not have had to clear those monies either.
Check with your auto insurer to see if you've exhausted adjectives of your coverage from this accident. They may be willing to income a part of it if you still have some medical payments coverage vanished.
From what you describe, though, it seems like you do owe your medical provider for what they compensated that they should not have. The money wasn't supposed to go contained by your pocket to begin with, so you're merely paying back what you should never have received surrounded by the first place. Ask them if they'll take payments. They probably will.
Sorry! I know you wanted a different answer, but this is the revolting truth. Source(s): 15 years as an insurance agent, retired.
Here's the deal (and sorry if someone already said this but I didn't read through all the answers)...when there's a coup¨¦ accident and the medical insurance pays w/o knowing you went through a sports car insurance, they can definitely take rear legs the money once they figure it out as they really weren't supposed to pay surrounded by the first place....
When you have more than 1 insurance company paying a bill, the one that pays first (in this case, the motor vehicle insurance) will do what they involve to do with the bill----pay whatever portion they clear. Then you (or your doctor, or hospital, or wherever the service happened) will submit the additional bill (if in attendance was any money left over after the motor insurance paid) to your health insurance. Your health insurance will look at what be already paid by the motor vehicle insurance and figure out what they will income additionally. The reason they asked for their money back is because they necessitate a statement (usually called and EOB or explanation of benefits) from the auto insurance to show what has already be paid on that bill. If they don't have that, they enjoy no way of knowing what they are supposed to pay.
For example, if your ER call on was $1,000 dollars, and your auto insurance pays $600, but they sent the bill to the health insurance w/o relating them you had auto insurance (so your health insurance have no idea you filed a claim next to the auto insurance and they think they're the only ones paying the claim) they'll clear their full amt, which may be like $900 for instance....the hospital is now getting channel more than they should be since 2 insurance companies are paying it w/ no idea the hospital is getting paid twice.
If the form insurance knew, they'd only be reimbursing base on the balance of $400, not the full amt. Soooo the health insurance will still money your bills--they just need statements from the auto insurance to say aloud how much has already been rewarded. Even if the auto insurance denied a bill, they just need a statement to say aloud they denied it.
If that doesn't make sense, feel free to e-mail me---kateekay(a)aol.com Source(s): I work for an insurance company
Related Questions:
Answers:
yes this is perfectly legal. Car insurance should other pay the bills incurred due to an auto accident.
Yes they can. In fact... this is the way it works.
Auto pays for injuries sustained within the accident.
Typically, Health Insurance pays your medical claims first. If there's a settlement, the auto pays for the injuries. Then, your health insurance is refund.
If you received a settlement, you are obligated to pay the hospital. If there be no settlement, your auto should be paying the hospital. If your auto is exhausted, then send the proof the auto insurance is exhausted to the medical insurance; & typically, they will wages more.
Yep. It's allowed. What happen was your medical insurance didn't check for coordination of benefits - some injuries automatically flag claims for that - basically, it's an insurance company's means of access of trying to "weasel" out of paying a claim. Why should they pay if someone else is responsible.
Your car insurance should hold been the primary insurance in this skin. You need to contact them ASAP and let them know what's going on, so they can take-home pay what's left of the bills so you don't get sent to collection and your credit ends up surrounded by the toilet. Source(s): I'm a medical biller
Yes, a form insurance company can absolutely take hindmost money after paying a claim, if its determined that they weren't the ones responsible for the payment.
If your auto's med pay be determined to be primary for the accident, then your strength insurer would request a refund for the payment they made as primary.
If your strength insurer should be liable for any amounts after the auto carrier's med pay exhausted, then the hospital would necessitate to send them an itemized statement of exactly what was remunerated by your auto carrier. That way, the robustness insurer can coordinate the benefits and make sure that the same services aren't individual paid twice. Source(s): 15 years working for health insurance companies and medical providers
Indeed they can.
Your medical and car insurance aren't supposed to put you in a better position than you be before the accident, so if they overpaid they sure should procure that money back. When you got the money from the hospital the best piece to have done would have be to call your medical insurer right then and return the money.
Also, your medical insurer isn't asking for the money rear because of the type of injury, they're asking for it back in slice because the injuries were the result of a car luck. State laws are clear in that your motor insurer should have paid first next to your regular medical coverage paying what your car insurer does not. Medical payments coverage, a terrific add-on to your auto insurance, should be used for medical bills up to that time anything else (medical payments can also pay lost wages, but medical bills should be paid until that time lost wages), so your medical insurer should not have had to clear those monies either.
Check with your auto insurer to see if you've exhausted adjectives of your coverage from this accident. They may be willing to income a part of it if you still have some medical payments coverage vanished.
From what you describe, though, it seems like you do owe your medical provider for what they compensated that they should not have. The money wasn't supposed to go contained by your pocket to begin with, so you're merely paying back what you should never have received surrounded by the first place. Ask them if they'll take payments. They probably will.
Sorry! I know you wanted a different answer, but this is the revolting truth. Source(s): 15 years as an insurance agent, retired.
Here's the deal (and sorry if someone already said this but I didn't read through all the answers)...when there's a coup¨¦ accident and the medical insurance pays w/o knowing you went through a sports car insurance, they can definitely take rear legs the money once they figure it out as they really weren't supposed to pay surrounded by the first place....
When you have more than 1 insurance company paying a bill, the one that pays first (in this case, the motor vehicle insurance) will do what they involve to do with the bill----pay whatever portion they clear. Then you (or your doctor, or hospital, or wherever the service happened) will submit the additional bill (if in attendance was any money left over after the motor insurance paid) to your health insurance. Your health insurance will look at what be already paid by the motor vehicle insurance and figure out what they will income additionally. The reason they asked for their money back is because they necessitate a statement (usually called and EOB or explanation of benefits) from the auto insurance to show what has already be paid on that bill. If they don't have that, they enjoy no way of knowing what they are supposed to pay.
For example, if your ER call on was $1,000 dollars, and your auto insurance pays $600, but they sent the bill to the health insurance w/o relating them you had auto insurance (so your health insurance have no idea you filed a claim next to the auto insurance and they think they're the only ones paying the claim) they'll clear their full amt, which may be like $900 for instance....the hospital is now getting channel more than they should be since 2 insurance companies are paying it w/ no idea the hospital is getting paid twice.
If the form insurance knew, they'd only be reimbursing base on the balance of $400, not the full amt. Soooo the health insurance will still money your bills--they just need statements from the auto insurance to say aloud how much has already been rewarded. Even if the auto insurance denied a bill, they just need a statement to say aloud they denied it.
If that doesn't make sense, feel free to e-mail me---kateekay(a)aol.com Source(s): I work for an insurance company
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